Remote Speech Therapy for Thinking, Memory & Communication (in Adults & Teens)

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This post is all about remote speech therapy

As a remote SLP of 6+ years, I am here to share my tips and tricks I have learned along the way. The landscape of cognitive rehabilitation (thinking, memory and communication) has transformed dramatically with the rise of remote (teletherapy) speech services.

What many don't realize is one of the most compelling facts about speech therapy: cognitive-communication disorders can be treated just as effectively through remote platforms as in traditional clinic settings.

✅ Why Remote Speech Therapy Works for Cognitive Rehabilitation

Speech therapy tele-therapy offers unique advantages for cognitive rehabilitation that go beyond simple convenience. When treating executive functioning deficits, attention disorders, or memory impairments, home speech therapy provides the ultimate generalization environment. Clients practice compensatory strategies in the actual setting where they'll use them, making carryover more natural and immediate.

The digital nature of teletherapy speech also allows for innovative approaches to cognitive training. Screen-sharing capabilities enable real-time collaboration on digital calendars, email management, and other authentic technology-based tasks that are central to modern executive functioning demands.

❌ When Remote Speech Therapy Will NOT Work for Cognitive Rehabilitation (in my humble opinion)

The idea of working remotely can be appealing for both the client and the clinician. These are cases where remote therapy has failed me personally.

✔️ Scenario 1: Low level Parkinson's patient. If the client has a more profound deficit, such as the inability to control their motor movement effectively or project their voice loud enough then remote therapy may not work.

✔️ Scenario 2: Remote therapy has been challenging in situations where I am working with clients whose are not tech saavy. In this case, I have had caregiver assist with setting up equipment and monitoring sessions.

✔️ Scenario 3: Any client that does not have access to a quiet background. Remote therapy does not work well with any type of background noise present.

✔️ Scenario 4: Nursing home setting. Although in some cases I feel it would be effective this is not a current practice that I am aware of.

Essential Components of Effective Speech Teletherapy for Cognitive Goals

Establishing the Therapeutic Environment

Successful speech therapy teletherapy activities for cognitive rehabilitation begin with optimizing the client's remote setup. Unlike articulation or voice therapy, cognitive rehabilitation requires minimal physical demonstration but maximum engagement with digital tools and authentic materials.

Ensure clients have access to screen-sharing capabilities, a quiet space with minimal distractions, and any compensatory tools they use daily (planners, smartphones, notebooks). The goal is to make the teletherapy speech therapy session feel like a natural extension of their daily cognitive demands.

Leveraging Digital Tools for Assessment and Intervention

Remote speech therapy platforms enable speech-language pathologists to assess and treat cognitive-communication disorders through dynamic, interactive methods. Digital whiteboards, canva, shared word document allow for real-time strategy mapping, shared documents enable collaborative problem-solving, and screen recording features let clients review their own cognitive processes.

Innovative Tele-therapy Speech Activities for Cognitive Rehabilitation

☎️ Chatting/Texting

Using the chat feature on zoom or talking back on forth on a document is one of my favorite speech therapy activities for a nuerodivergent student who has difficulty with verbal expression. When I write down questions, verses ask them out loud I can frequently help them avoid an echolalic response and give a factual answer.

Having that written cue is SO beneficial. We can work on increasing out rapport, learning more about the student's preferences, avoid echolalic responses and mimic how real life occurs.

When I say real life, I mean SO much of our world is now focused on interaction through social media. This requires navigating a web browser, using a keyboard on the computer or the phone, and interacting through written language. I will save the communication threads so we can build upon them each session. I use a program called Canva so I can quickly add a picture to my written communication if the student needs additional cues. Then I organize my files into different folders so I can easily pull it up for the next session.

📡 Digital Note-Taking

During tele-therapy speech sessions, have clients practice taking notes on information you present (instructions for a task, details of a scenario, or key points from a passage). Then have them immediately use those notes to complete a related task.

This mirrors the cognitive demands of work meetings, medical appointments, and educational settings.

The beauty of speech therapy tele-therapy is that you can review their notes in real-time through screen-sharing and provide immediate feedback on organization, completeness, and functional utility.

⚙️ Cognitive Flexibility

Ask the client to type three items in the chat, then switch and have them say three items out loud. After that, share your screen and ask them to point out one item they see. Then ask them to make a list in a document, such as canva, word or whatever application they have accessible to them. This could be the notes section on their phone. Bonus: Have them actually write down their current grocery list needs.

🗝️ Work On Executive Functioning With Real World Tasks

Use this worksheet (or create a similar concept) on how to plan a vacation. Include looking up flight times, accommodations, activities and miscellaneous charges. Set a budget at the beginning and have your client try to stay within the budget to target self-monitoring, organization, planning and cognitive flexibility. Use the screen share feature so you can assist along the way! If you don't want to create your own concept I created a structured activity outlining this exact task!

Purchase This Vacation Planning Task To Focus On Real-World Tasks That Target Executive Functioning

⏳ Timed Organization Tasks

Present clients with a deliberately disorganized digital environment (a folder of randomly named files, a cluttered desktop screenshot, or a messy spreadsheet) and have them reorganize it within a time limit while explaining their organizational logic aloud.

This targets planning, categorization, processing speed, and metacognition.

 🔌 Virtual Life Management Simulations

Have clients share their screen while navigating real-world digital challenges: managing a cluttered inbox, scheduling appointments around conflicts in their actual calendar, or researching and comparing products online while tracking pros and cons.

These speech tele-therapy activities target multiple executive functioning domains simultaneously such as organization, decision-making, sustained attention, and working memory.

Group Speech Therapy in the Remote Setting

One of the unexpected benefits of speech teletherapy is how effectively it facilitates group speech therapy for cognitive rehabilitation. Virtual breakout rooms allow for peer problem-solving, and shared digital workspaces enable collaborative projects that target cognitive skills.

Consider these group formats:

✔️ Peer Strategy Workshops: Have group members share compensatory strategies they've discovered, then practice applying each other's techniques to common scenarios. This builds metacognitive awareness and expands each person's cognitive toolbox.

✔️ Collaborative Planning Projects: Assign the group a complex multi-step project (planning a hypothetical fundraiser, creating a presentation, or organizing a virtual event) that requires delegation, timeline management, and coordination. This mirrors workplace cognitive demands while providing peer support.

✔️ Current Events Discussion Groups: Structure discussions around recent news that require analysis, perspective-taking, and verbal reasoning. The remote format eliminates geographic barriers, potentially creating more diverse groups with richer discussions.

The social accountability inherent in group speech therapy provides motivation that individual sessions sometimes lack, while the cognitive demands of tracking multiple speakers and managing turn-taking add therapeutic value.

Facts About Speech Therapy That Change in the Remote Context

Here are important realities about speech therapy teletherapy that clinicians and clients should understand:

✔️ Attention demands are different, not necessarily harder: While screen fatigue is real, many clients with attention deficits actually perform better in home speech therapy settings where they can control sensory input and eliminate the cognitive load of navigating unfamiliar clinical environments.

✔️ Family involvement increases naturally: Remote sessions make it easier for family members to observe portions of therapy and learn how to support cognitive strategy use, leading to better outcomes.

✔️ Technology becomes part of the intervention: Rather than avoiding technology challenges, savvy clinicians use them as opportunities to target problem-solving, frustration tolerance, and flexible thinking.

Structuring Effective Speech Therapy Teletherapy Activities

The most successful teletherapy speech activities for cognitive rehabilitation follow these principles:

✔️ Front-load the cognitive challenge: Don't waste bandwidth on lengthy explanations. Jump quickly into cognitively demanding tasks and provide support as needed.

✔️ Use authentic materials: Pull from clients' actual emails, calendars, and documents whenever possible. If using generic materials, ensure they closely mirror real-world cognitive demands.

✔️ Build in reflection time: After each activity, spend time discussing what strategies worked, what didn't, and how the client can apply these insights independently.

✔️ Vary the format: Alternate between screen-sharing activities, verbal tasks, written assignments, and movement breaks to maintain engagement and challenge different cognitive systems.

✔️ Create homework with built-in accountability: Use the remote platform to assign tasks that generate digital evidence (screenshots of completed planners, email drafts, recorded summaries) that you can review together next session.

Overcoming Common Challenges in Speech Teletherapy

🔴 Challenge: Clients struggle with the technology itself.

🗣️ Solution: Use this as a cognitive intervention opportunity. Problem-solving technical difficulties targets metacognition, frustration tolerance, and adaptive thinking—all key executive functioning skills.

🔴 Challenge: Home environments have more distractions.

🗣️ Solution: Incorporate distraction management into your speech therapy teletherapy activities. Teach clients to use environmental modifications, attention strategies, and self-monitoring techniques in their actual challenging environment.

🔴 Challenge: Building rapport feels more difficult remotely.

🗣️ Solution: Use the intimacy of entering someone's home environment to build connection. Comment on their space, acknowledge their real-life context, and show genuine interest in how cognitive challenges manifest in their daily routine.

Measuring Progress in Remote Cognitive Rehabilitation

✔️ Remote speech therapy offers unique advantages for tracking cognitive progress.

✔️Digital task completion times, screenshots of organizational systems, and recorded think-aloud protocols provide concrete evidence of improvement that can be quantified and shared with clients.

✔️Create a shared digital document where clients track their own progress on specific cognitive goals. This builds self-monitoring skills while providing data for clinical decision-making.

The Future of Tele-therapy Speech for Cognitive Rehabilitation

✔️ As virtual reality and augmented reality technologies become more accessible, the possibilities for speech tele-therapy activities will expand dramatically.

✔️ Imagine cognitive rehabilitation sessions where clients navigate virtual environments that challenge prospective memory and multitasking in immersive, controllable settings.

✔️Even without advanced technology, current remote speech therapy capabilities provide powerful tools for addressing cognitive-communication disorders in functionally relevant ways.

Conclusion

Remote speech therapy for cognitive rehabilitation represents not just a substitute for in-person services, but often an enhancement. The combination of authentic environmental context, digital tool integration, and increased accessibility makes speech therapy tele-therapy particularly well-suited for addressing executive functioning and cognitive-communication needs in adolescents and adults.

By embracing the unique affordances of the tele-therapy format rather than simply replicating in-person approaches through a screen, clinicians can deliver cognitive rehabilitation that is engaging, functional, and measurably effective. The key is recognizing that home speech therapy for cognitive goals isn't a compromise—it's often the optimal setting for learning strategies that must generalize to daily life.

Whether working individually or in group speech therapy formats, the remote delivery of cognitive rehabilitation services has proven its value and will undoubtedly continue to evolve as an essential component of comprehensive speech-language pathology practice.

Ready to expand your tele-therapy speech therapy practice? Focus on authentic, technology-integrated activities that challenge cognitive systems in the contexts where clients actually need to use them.

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